Provider Demographics
NPI:1750372918
Name:SINHA, PURENDRA P (MD)
Entity type:Individual
Prefix:
First Name:PURENDRA
Middle Name:P
Last Name:SINHA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 US HWY 19
Mailing Address - Street 2:
Mailing Address - City:HOLIDAY
Mailing Address - State:FL
Mailing Address - Zip Code:34691
Mailing Address - Country:US
Mailing Address - Phone:727-942-7070
Mailing Address - Fax:727-934-9457
Practice Address - Street 1:3000 US HWY 19
Practice Address - Street 2:
Practice Address - City:HOLIDAY
Practice Address - State:FL
Practice Address - Zip Code:34691
Practice Address - Country:US
Practice Address - Phone:727-942-7070
Practice Address - Fax:727-934-9457
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2013-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME339552085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL202820OtherAVMED
FLP00421718OtherRAILROAD MEDICARE
FL26180OtherBCBS
FL378380400Medicaid
FL26180PMedicare PIN
FL26180RMedicare PIN
FL26180BMedicare PIN
FL26180UMedicare ID - Type Unspecified
FL26180JMedicare PIN
FL26180MMedicare PIN
FL26180LMedicare PIN
FL26180IMedicare PIN
FL26180NMedicare PIN
FL26180QMedicare PIN
FL21680FMedicare PIN
FL202820OtherAVMED
FLD49481Medicare UPIN
FL378380400Medicaid
FL26180OMedicare PIN